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General NPI Number Information
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NPI Number | 1124334826
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Entity Type | Organization
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Legal Business Name | JESSICA BARCESSAT DMD, P.C.
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Dates
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Enumeration Date | 08/19/2010
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Last Update Date | 05/20/2011
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Provider Practice Location Address
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Address Line | 2090 7TH AVE
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City | NEW YORK
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State | NY
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Zip | 10027-4990
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Country | US
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Telephone | 917-386-4336
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Fax |
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Provider Business Mailing Address
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Address Line | 2090 7TH AVE
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City | NEW YORK
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State | NY
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Zip | 10027-4990
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Country | US
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Telephone | 917-386-4336
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Fax |
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Authorized Official
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Title or Position | DENTIST
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Name | JESSICA BARCESSAT
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Credential |
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Telephone | 917-386-4336
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 054774-1
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License Number State | NY
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